Safe and Appropriate Use of GLP-1 RAs in Treating Adult Patients With Type 2 Diabetes and Macrovascular Disease.

Over the past decade, the type 2 diabetes (T2D) treatment landscape has evolved, allowing for more therapeutic options and the opportunity to tailor treatments to achieve patient treatment goals. In this video roundtable series, James LaSalle, DO; Lucia M. Novak, CRNP; and Lawrence Blonde, MD, MACE, FACP, discuss the mechanisms of action and clinical trial data for use of glucagon-like peptide 1 receptor agonists (GLP-1 RAs) in the safe and effective primary care management of individuals with T2D and macrovascular disease.

Conquering diabetes therapeutic inertia: practical tips for primary care.

Diabetes is a complex condition that is largely self-managed. Decades of scientific evidence has proved that early glycemic control leads to improved microvascular and macrovascular outcomes in people with diabetes mellitus. Despite well-established management guidelines, only about half of the patients with diabetes achieve glycemic targets, and only one in five patients achieve metabolic control (blood pressure, lipid, and glucose targets), and both patients and physicians find themselves stuck in a rut called therapeutic inertia (TI).

Addressing Therapeutic Inertia in 2020 and Beyond: A 3-Year Initiative of the American Diabetes Association.

Research has shown that getting to glycemic targets early on leads to better outcomes in people with type 2 diabetes; yet, there has been no improvement in the attainment of A1C targets in the past decade. One reason is therapeutic inertia: the lack of timely adjustment to the treatment regimen when a person's therapeutic targets are not met. This article describes the scope and priorities of the American Diabetes Association's 3-year Overcoming Therapeutic Inertia Initiative.

Uncommon Presentations of Diabetes: Zebras in the Herd.

The majority of patients with diabetes are diagnosed as having either type 1 or type 2 diabetes. However, when encountered in clinical practice, some patients may not match the classic diagnostic criteria or expected clinical presentation for either type of the disease. Latent autoimmune, ketosis-prone, and monogenic diabetes are nonclassical forms of diabetes that are often misdiagnosed as either type 1 or type 2 diabetes.

Role of ultrafast-acting insulin analogues in the management of diabetes.

To control both fasting and prandial plasma glucose levels in people with diabetes, insulin therapy must mimic "normal" physiological insulin secretion as much as possible. This is achieved with a long-acting insulin injected once or twice daily and a bolus of insulin injected before every meal. Prandial (bolus) insulin can either be regular human insulin (RHI) or a rapid-acting insulin analogue (RAIA).

Optimizing Insulin Therapy: Basal Insulin and Beyond.

Data suggest that in patients with type 2 diabetes, there has been little or no improvement in glycated hemoglobin (A1C) and other glycemic parameters over recent decades. In this digital roundtable discussion, the speakers address challenges faced every day in clinical practice, and provide practical advice regarding how primary care clinicians can overcome clinical inertia. The speakers particularly focus on how to manage patients who are treated with basal insulin, yet are unable to achieve good glycemic control.

Bolstering your armamentarium with SGLT2 inhibitors.

Sodium-glucose cotransporter-2 inhibitors have a unique mechanism of action in the kidneys that causes glucosuria, which lowers plasma glucose. They are also associated with reduced body weight and BP, and a low incidence of hypoglycemia. This article reviews the pharmacologic profiles and clinical implications of canagliflozin, dapagliflozin, and empagliflozin.

Bolstering your armamentarium with SGLT2 inhibitors.

Sodium-glucose cotransporter-2 inhibitors have a unique mechanism of action in the kidneys that causes glucosuria, which lowers plasma glucose. They are also associated with reduced body weight, BP, and a low incidence of hypoglycemia. The pharmacologic profiles/clinical implications of canagliflozin, dapagliflozin, and empagliflozin are discussed in this article.

Insulin glargine 300 units/mL: a guide for healthcare professionals involved in the management of diabetes.

Unlabelled: Insulin glargine 300 units/mL: Insulin glargine 300 units/mL (Gla-300) is a formulation of insulin glargine that delivers the same number of insulin units in one-third of the injectable volume of insulin glargine 100 units/mL (Gla-100). Glucose control: Recently approved in the United States and in Europe for use in type 1 and type 2 diabetes, Gla-300 has a more constant and evenly distributed glucose-lowering effect compared with Gla-100, with a duration of action beyond 24 hours and lower within-day and between-day intra-individual variability in blood glucose levels. These benefits translate into predictable and sustained glucose control from a once-daily injection, with potential for fewer hypoglycemia episodes and less weight gain.